1 


IVERSITY  BULLETIN 

New  Series,  Vol.  XIV,  No.  25.  June,  1913 


UNIVERSITY  OF  MICHIGAN 


PASTEUR 

INSTITUTE 


Suggestions  as  to  the  Proper  Procedure 
in  Cases  of  Suspected  Rabies — the 
Safe-Guarding  of  Persons  Bit- 
ten by  Dogs — the  Care 
of  Suspected  Mad 
Dogs 


Attn  Arfcuur 

PUBLISHED  BY  THE  UNIVERSITY 

1913 


SUGGESTIONS  AS  TO  THE  PROPER  PROCED- 
URE IN  CASES  OF  SUSPECTED  RABIES— 
THE  SAFE-GUARDING  OF  PERSONS 
BITTEN  BY  DOGS— THE  CARE  OF 
SUSPECTED  MAD  DOGS 


By  James  Gordon  Cumming,  M.  D.,  In  charge  of 
the  Pasteur  Institute  of  the  University  of  Michigan 


The  first  fact  which  should  be  borne  in  mind  when 
dealing  with  a case  in  which  a dog  has  bitten  a human  be- 
ing or  other  animal,  is  this:  Rabies  can  be  caused  only 
by  the  bite  of,  or  the  entrance  into  a wound  of  the  saliva 
from,  an  animal  actually  mad.  A dog  which  is  merely 
vicious  may  wound  severely,  but  its  bite  cannot  cause  the 
disease. 

Therefore,  the  important  question  when  a person  is 
bitten,  is  to  determine  whether  or  not  the  dog  was  mad 
at  the  time  the  injury  was  inflicted.  In  order  to  decide 
this  the  dog  should,  if  possible,  be  chained  or  otherwise 
confined  and  observed  for  at  least  ten  days.  As  long 
as  the  dog  remains  healthy,  the  individual  bitten  is  in 
no  danger.  If  the  animal  shows  no  symptoms  during 
the  entire  ten-day  period  one  can  conclude  that  the  per- 
son bitten  was  not  exposed  to  the  disease.  A rabid  ani- 
mal can  transmit  the  disease  only  during  the  stage  of 
illness  and  during  two  days  preceding  the  first  symptom. 
The  duration  of  the  disease  is  not  more  than  ten  days, 
usually  from  three  to  five  days.  A rabid  dog  inevitably 
dies  within  ten  days  after  the  appearance  of  the  first 
symptom.  If  the  animal  suspected  of  having  rabies  is 
proved,  by  the  fact  that  it  continues  to  live , to  be  free 
from  the  disease,  there  is  no  reason  for  apprehension  on 
the  part  of  those  exposed.  While  it  may  be  desirable  to 
kill  a dog  on  account  of  its  vicious  disposition,  this  should 
not  be  done  in  any  case  within  ten  days  of  the  time  that 
it  has  actually  bitten  anyone.  In  many  cases,  when  a per- 
son is  bitten,  the  dog  is  immediately  killed.  This  is  jus- 


tifiable  only  in  case  the  disease  in  the  dog  was  well  de- 
veloped and  there  was  danger  in  attempting  to  appre- 
hend the  animal.  Under  such  conditions  the  procedure 
to  be  followed  is  as  in  “Points  2 and  3”  below. 

When  a person  is  bitten  by  a stray  dog,  which  dis- 
appears and  cannot  be  observed,  or  its  status  otherwise 
learned,  it  is  advisable  to  take  the  Pasteur  treatment 
without  delay. 

There  are  two  forms  of  rabies,  the  so-called  mania- 
cal, or  furious  rabies,  and  the  dumb  rabies.  In  either 
form  the  chain  of  symptoms  is  fairly  well  defined. 

In  maniacal  rabies,  the  animal  is  excited,  changing 
its  position  frequently  and  attacking  whatever  comes  in 
its  way,  especially  dogs.  This  excitement  may  be  marked 
or  mild;  usually  it  is  marked.  Following  this  is  the  stage 
of  partial  paralysis,  which  makes  its  appearance  usually 
by  the  second  or  third  day.  There  may  be  partial  paraly- 
sis of  the  hind  legs,  which  is  shown  by  the  tendency  to 
sway  from  one  side  to  the  other  when  walking,  and  by  a 
humped  back.  Drooping  of  the  lower  jaw,  due  to  paralysis, 
is  a definite  symptom  of  rabies.  Owing  to  this  paralysis 
and  that  of  the  throat  muscles,  the  dog  is  unable  to  eat  or 
drink  even  though  it  may  make  repeated  attempts  to<  do 
so.  The  paralysis  may  be  confined  to  one  side  of  the 
body.  When  in  this  condition  the  head  is  turned  side- 
wise  and  when  the  animal  is  lying  down  the  fore  legs 
are  often  crossed.  If  while  in  this  unilateral  paralytic 
condition,  the  dog  should  move  about  it  almost  invariably 
turns  to  the  same  side.  There  is  finally  complete  paraly- 
sis during  which  the  animal  may  have  spasms.  This 
stage  may  last  two  days,  ending  in  death. 

In  the  second  or  dumb  form  of  rabies  there  is  no 
general  excitement;  the  paralytic  symptoms,  however, 
are  marked.  In  this  form  of  rabies  the  dog  takes  no 
notice  of  its  surroundings.  He  wanders  aimlessly  and  as 
a rule,  does  not  attempt  to  bite.  Paralysis  of  the  lower 
jaw  is  the  most  common  symptom  of  dumb  rabies.  In 
this  condition  the  dog  may  present  the  appearance  of 
an  animal  having  a bone  in  its  throat.  An  attempt  to 
examine  the  dog’s  throat  should  not  be  made,  for  in  so 
doing  saliva  may  be  introduced  into  wounds  on  the  hands. 
Infection  through  an  open  wound  is  not  to  be  considered 
less  dangerous  than  the  actual  bite  of  a rabid  animal. 
Following  this  symptom  any  one  of  the  other  forms  of 


3 0112  105759192 

partial  paralysis — general,  posterior,  or  unilateral — be- 
comes apparent.  There  is  finally  complete  paralysis  and 
inevitable  death,  usually  within  five  days. 


IN  BRIEF 

The  following  points  should  be  borne  in  mind : 

Point  i.  If  possible  to  avoid  doing  so,  do  not  kill  a 
supposedly  rabid  dog ; keep  him  securely  chained  or  con- 
fined for  ten  days.  A negative  diagnosis  may  be  made 
from  the  living  animal,  if  during  the  ten-day  confinement 
it  remains  healthy.  As  long  as  it  remains  healthy  it 
should  not  be  killed  and  there  is  no  need  to  send  it  for 
laboratory  diagnosis. 

Point  2.  If  an  animal  suspected  of  rabies,  dies,  its 
head  should  be  sent  immediately,  or  better,  brought  by 
messenger,  to  the  Pasteur  Institute  for  laboratory  diag- 
nosis. Address  all  such  parcels : '‘Pasteur  Institute,  Med- 
ical Building,  University  of  Michigan,  Ann  Arbor,  Mich- 
igan. Rush.  Prepaid.” 

Point  3.  If  the  report  of  the  Institute  states  that  the 
dog  had  rabies,  anyone  infected  by  the  saliva,  either 
through  a bite  or  other  wound,  should  report  immediately 
at  the  Pasteur  Institute  for  treatment.  The  cost  of  this 
treatment  is  $25.00  to  residents  of  Michigan.  No  provis- 
ion is  made  by  the  Pasteur  Institute  for  board  or  room, 
but  these  may  be  obtained  in  Ann  Arbor  at  a nominal 
cost. 

Point  4.  In  localities  where  the  disease  is  known  to 
exist,  all  dogs  should  be  muzzled  with  either  wire  or 
properly  fitting  idrap  muzzles.  The  ordinary  strap  muz- 
zle is  in  most  cases  useless  in  serving  the  purpose  for 
which  it  is  intended  To  prevent  the  animal’s  biting  the 
muzzle  should  be  properly  fitted. 

Point  5.  All  dogs  known  to  have  been  bitten  by  a 
rabid  dog  should  be  killed. 

Point  6.  As  an  essential  preliminary  measure  all 
wounds  through  which  the  saliva  of  the  animal  may  have 
entered,  whether  bites  or  scratches,  should  be  cauterized 
immediately  with  commercial  formalin.  This  precaution- 
ary measure,  indeed,  should  not  be  neglected  after  a 
delay  of  one  or  even  two  days. 

Entered  as  2d-class  matter  at  the  postoffice  at  Ann 
Arbor,  Mich. 


THE  ANN  \RBDR  PRESS 


